
7^/5V 



Class _ 



MEMOIR 



THOMAS S. Klf[KBf|IDE, M. D., LL, D 



PREPARED BY DIRECTION 



-OF THE- 



ASSOCIATION OF MEDICAL SUPERINTENDENTS 



-OF— 



^ii|mtan KnstiMoiis fflt i^t fpmt, 



-BY- 



JOHN CURWEN, M. D., 
CHARLES H. NICHOLS, M. D., 
JOHN H. CALLENDER, M. D., 

READ AT THE MEETING OF THE ASSOCIATION AT 

Saratoga, New York, June 16, 1885 



WARREN, PA.: 
E. COWAN & CO., PRINTERS. 

1885. 






i\\o^^ 







)T the meeting of the Association of Medical Superintend- 
ents of American Institutions for the Insane, held in 
Philadelphia on May 13, 1884, and the following days, 
the following proceedings were had in relation to Dr. Thomas 
S. KiRKBRiDE, one of the original members of the Association 
and so prominent in its councils during the whole term of its 
existence : 

Dr. Curwen offered the following resolution : 

Resolved, That in the death of our fellow-member, Dr. Thomas S. 
Kirkbride, this Association has lost one of its ablest associates, who, 
during the whole period of its existence had given to it most earn- 
est and devoted thought and attention, and whose counsels were 
always wise, cautious and most enlightened. 

A kind, warm-hearted and sympathizing friend, a faithful and 
prudent counsellor, a genial and cheerful companion, and a most 
able, laborious and devoted physician and superintendent ; no one 
who was privileged to know^ him in these relations can fail to feel 
the great blank which has been made by his removal. 

Privileged to continue in active, continuous service longer than 
any other member, his latest thoughts were given to the considera- 
tion of those things which w^ould most benefit those for whom, for 
more than forty years, he had thought and labored. 

Dr. Curwen : I move, also, that the President appoint a com- 
mittee to prepare a memorial of Dr. Kirkbride, to be preserved 
in the minutes of the Association. 

Dr. Gray : The resolution is before the Association. 

Dr. Grissom : Mr. President — In this connection I desire to 
lay before the Association a resolution adopted by the Board of 



4 
Directors of the North CaroHna Asyhim at Raleigh. Dr. Kirk- 
bride's reputation, fame and service, outside of the State of 
Pennsylvania, are, perhaps, nowhere better appreciated than in 
the State which I represent. During his career, he not only had 
a large number of patients from that State, but was always ready 
to aid by wise counsel in matters pertaining to the provision for 
and treatment of the insane. 

The resolutions were then read by the Secretary as follows : 

Whereas, The Board of Directors of the North Carolina Insane 
Asylum have heard with deep regret the announcement of the death 
of Dr. Kirkbride, therefore, be it 

Resolved, That the Board desires to exj^ress and record its sense of 
appreciation of the eminent services rendered to humanity by Dr. 
Kirkbride, during his half century of service as Superintendent of 
asylums for the insane. 

That the unfortunate insane have been deprived of a great, kind 
and tireless friend, and the managers of asylums of a wise benefac- 
tor and teacher. 

That a copy of these resolutions be sent to the family of the de- 
ceased as a mark of condolence for their personal bereavement, to 
the authorities of the Institution over which he presided with such 
signal success, and to the Assembly of Superintendents soon to 
meet. 

NoKTH Carolina Insane Asylum, 
Raleigh, N. C, May 5, 1884. 

Dr. Grissom : Mr. President and gentlemen of this Associa- 
tion — When the garlands of remembrance are hung at the door 
of the tomb of such a man as Dr. Kirkbride, the State which I 
have the honor to represent thinks it eminently proper that a 
spray of cypress should be offered from the South. It is good 
for us to pause and reflect upon the lesson which his example 
teaches, and to think of a life which for more than half a cen- 
tury was the sweet, serene pathway of a good man, intent upon 
his duty, with a heart warm with love for his fellow-men, and a 
spirit as true to the demands of virtue and honor as the needle to 



5 
the pole. It is almost an act of supererogation to speak in this 
or any other community of Dr. Kirkbride's fame. His name in 
medical annals and councils has long been honored as a house- 
hold word ; and his memory around thousands of firesides will 
be cherished with the veneration of a Roman's reverence for his 
household god. This sun in the firmament of our specialty, 
whose bright and brilliant rays in the early morn of its career 
scattered wide and far the mists of mental gloom, and which 
shone with genial and gentle warmth through the long summer 
day, unobscured by a single cloud, has at last calmly and majes- 
tically set, leaving a surrounding afterglow, soft and beautiful, 
lingering upon the horizon of its career reluctant to vanish from 
the scene of its glory. Let us thank God that we have been per- 
mitted to witness this example of greatness and goodness, shi- 
ning through such a long life of usefulness and unselfishness. 
Let us honor the memory and practice the virtues of this sage, 
who moved among his followers like a genius, holding the vol- 
ume of accumulated wisdom and dispensing with a modesty all 
his own, from the abundance of that knowledge which expe- 
rience collects and diligence preserves. We are wont to praise 
the gallant mariner who rescues a drowning man ; Grace Darling 
will live forever in story and in song \ but how can pen or tongue 
tell the tale of this gray-haired hero, whose career was one life- 
long struggle to save from despair those imprisoned spirits upon 
whom the world had already set the grave-stone of oblivion ? 

" To dumb forgetfulness a prey." 

Think how this man of delicate frame and soft and gentle 
speech, stood for a lifetime on the ocean-side of misfortune 
where the mental wrecks of numerous victims were tossed by the 
waves, and with cool head and unshrinking nerve rescued from 
destruction their frail barks and wafted them once more with 
Reason at the helm and Hope at the prow, to seek yet again a 
prosperous voyage and a peaceful haven. Clothed and in their 
right minds, those to whom the precious jewels of man's inheri- 
tance have been restored, bring to-day the brightest gems that 
sparkle in their mental crown, to adorn the shrine of Kirkbride's 
fame. His mission was at last ended. He died, but not unex- 
pectedly. Fie kept his lamp trimmed and oil burning, for the 



coming of the bridegroom. He cherished a constant remem- 
brance of another life than this, another judge than man, anoth- 
er ordeal than human opinion. 

He did his duty at all times, in all places, to all men, and he 
enjoyed a wealth of noble thoughts, memories of noble actions 
and hopes of a noble felicity. We have on this occasion 
mingled emotions of sorrow and gladness. We mourn that Dr. 
Kirkbride is dead ; we rejoice that Dr. Kirkbride can never die. 
That omnipotent Providence which overrules our destinies has 
only removed from this to a higher state of existence a good 
man, a kind father, a loving husband, a faithful friend, a pure 
patriot, a distinguished philanthropist, an eminent physician, a 
sincere Christian. In this dispensation we lose a companion, 
his family a protector, the poor a benefactor, the afflicted a com- 
forter, society an ornament, philanthropy an instructor, the pro- 
fession a votary, religion an exemplar. But our temporal loss is 
his eternal triumph. So dear to him did the path of duty be- 
come, from long years of faithful habit, that as age gently with- 
ered his strength he tottered on toward honor and immortality. 
He went down to the grave calmly and without a fear. His ex- 
ample will teach on earth while his spirit rejoices with God. 

Dr. Earle : As I cannot trust my organs of speech upon such 
an occasion, I wish simply to say that I entirely and most cor- 
dially approve of the resolution and the remarks that have been 
made. 



Dr. Gray : Gentlemen of the Association — Before putting 
this motion I would like to add a few words to what has already 
been said in regard to Dr. Kirkbride. I first knew him more 
than thirty-five years ago, when I was a student in this city and 
was in a hospital here. I knew him then in association wjth 
other young men, as a friend of young men. With age, dignity 
and position, he was remarkably accessible to young men. It 
seemed to give him the greatest pleasure and satisfaction to ad- 
vance them and encourage them. From that date to the time of 
his death I knew Dr. Kirkbride well as a friend, and the elo- 



7 
quent remarks of Dr. Grissom have appropriately portrayed the 
beautiful character of this distinguished physician and superin- 
tendent. As Dr. Grissom has said, he was delicate in person, 
apparently frail in physical structure, but he possessed a large 
spirit. He was a man of great energy, great vigor of thought 
and action, though generally quiet in his movements. He 
seemed to be a natural leader in his profession. Men followed 
him, listened to him, recognized him as a man of thought and 
reflection with a power of formulating his ideas distinctly and 
clearly, and of presenting them so plainly that I hardly recall an 
instance where his propositions were not accepted, because they 
were completed in his own mind before he presented them, — 
like the sculptor who fashions and perfects the figure before he 
unveils it to the world, so that they who see it hear not the sound 
of the hammer or chisel, nor see the dust produced in its forma- 
tion, so Dr. Kirkbride wrought his work, fashioned in the mold 
<yf thought, and polished by experimental application, that it 
came perfect as from the hands of the workman. 

When we look back through his history we must estimate him, 
not as though we judged him to-day, as though he had arisen 
now or within the last quarter of a century. It must be borne 
in mind he came upon the stage at a time when there was little 
that could be said in regard to the treatment of the insane. As 
we look back now we see that little had been done. VVe must 
go back with him as a man who framed (for he was one of its 
framersy the constitution, so to speak, under which this Associa- 
tion lives and acts. He was connected conspicuously with all 
the operations in organizing the Association, and with all of its 
fundamental resolutions and its great work from that day to this ; 
his hand touched everything. More than this, in the institution 
to which he was so early appointed, years before the existence of 
this Association, he commenced the work of development of the 
structure of psychological medicine in this country, — building 
from within and building from without. — not alone a physical 
structure, but laying down principles for the guidance of those 
who might come after him. He was a progressive, yet conserva- 
tive man, with that self-poise which kept him from being carried 
away by seeming advances, and with that patience of judgment 



8 

which led him to examine before approval or rejection, the ideas 
of others. He was among those who early recognized that the 
phenomena of disease were not made up from books, but only 
disclosed to the patient, toiling observer, in the light of expe- 
rience. 

He was himself a worker. The great utility of his life came 
from within ; his aims were high and pure, and he urged his 
opinions with a simplicity and earnestness and unselfishness 
which made them not only unanswerable but irresistible. Any 
one reading the memorial of his life and work, traced by the 
hand and heart of his accomplished wife, through the long years 
of his usefulness, cannot but be struck with the fact that he 
seems to have been associated with the origin and development 
of every advance made in the care of the insane. The narra- 
tive is, in fact, a compendium of the subject during the last half 
century, and Dr. Kirkbride stands as a foremost figure, espe- 
cially in all that relates to the practical work accomplished in 
providing and organizing institutions of this class for our fellow- 
men. 

As Dr. Grissom has said, he was not a man of this State nor 
of this great and good city ; he was a man of the world — whose 
name is written in every State and in every country in the char- 
acteristics which Dr. Grissom has so eloquently portrayed. A 
man of strong, firm character, of great decision of will, of sound 
judgment, of high purposes ; he was withal, the gentlest of men. 
He had a sweetness of manner which was like that of a woman, 
a tenderness of spirit which reached every man he met, and I 
venture to say there was no man with whom he came in contact 
that did not feel this. So he goes to rest ! But, as Dr. Grissom 
has well said, "Dr. Kirkbride can never die." His name will 
never perish from the earth while medical science and humanity 
have to consider the great questions which pertain to man and 
his welfare in this world and which reaches on towards the world 
to come. 

Dr. Nichols : I feel quite unable to express my profound 
sense of the loss this Association and our common ])rofession, 



9 

and all those bound to him by ties of blood and friendship, have 
sustained in the death of Dr. Kirkbride. One of the founders 
of this Association, he was its wise counsellor and strong support 
through every vicissitude of its past history until failing health 
compelled him to relinquish an active participation in its work. 
No member in the present or in the long past will or would, I 
believe, consider it invidious to give him preeminence in depth 
and constancy of interest in its welfare. His zeal for the wis- 
dom of its course and for its reputation and usefulness, was both 
affectionate and conscientious. He never forgot this love. And 
his interest in the Association as a body that had long led the 
rapid advance of mental medicine on the western continent, 
was naturally reflected to its members upon whose wisdom and 
constancy its reputation and authority must at all times depend. 



. Every member of the Association could justly clairti the honor 
of his friendship. I first saw Dr. Kirkbride at the place of his 
great life-work, the Pennsylvania Hospital for the Insane, in 
March, 1843, during that happy period that intervenes between 
a successful examination for the degree of doctor of medicine 
and the public reception of the diploma. I did not see him 
again until the meeting of the Association in 1849, in the city of 
Utica, which I attended as a member, by virtue of my appoint- 
ment a few weeks before to the charge of the Bloomingdale 
Asylum in the city of New York. 

From that time till his lamented death — for more than a gen- 
eration — our friendship was intimate and on my part, and as I 
believe on his, unbroken by the slightest relaxation in its 
warmth — much less in its constancy, and the counsel, moral 
support and happiness that I have derived from it I shall never 
be able to adequately acknowledge. I am quite unprepared to 
present either a critical or extended analysis of the opinions or 
labors of Dr. Kirkbride, but wish in a word to bear testimony to 
what always seemed to me the most conspicuous and admirable 
traits of his character. I refer to his remarkable fortitude and 
constancy, to which I think his useful and illustrious life is more 
attributable than to his abilities and attainments, which were 



certainly of a high order. Other men have shown equal courage 
and resource in periods of danger or difficulty. Others have 
been equally conscientious and were able and learned, but for 
unswerving and untiring professional and administrative labor in 
much bodily weakness through many years of his life, in steady, 
calm, uncompromising adherence to what he considered right in 
the social order and in professional practice and relations, some- 
times in later years against opposition and even obloquy in a 
community of which he had been a conspicuous benefactor, and 
in unfaltering trust in the Divine order and beneficence all 
through a long life, I consider him perhaps the most remarkable 
man it has been my fortune to know, and one of the most re- 
markable in history. Opinions in our specialty of medicine 
may be divided into two classes, those that are subordinate and 
affected by times and circumstances, and those that are more 
fundamental and constant. Those relating to many details of 
construction of hospitals and their management, in respect to 
which Dr. Kirkbride was so much of a pioneer in the specialty 
as to have been compelled to form his own opinions and prac- 
tice, to which he tenaciously adhered, will undergo more or less 
change, but those relating to the amenability of insanity to early 
treatment, to the relative value of the skill in treatment that is 
based on observation and practice, and that that is based on 
reading and theory — not to say conceit, — to the claims of the 
poor insane to liberal public provision for their support and 
treatment and, above all, to the gentle, painstaking, patient 
care that the insane require, are fundamental and much less like- 
ly to change in practical minds. Upon these points Dr. Kirk- 
bride entertained what I regard as sound and at the same time 
eminently humane and liberal views ; and I venture to predict 
that, in general, their wisdom will be sustained by time and ex- 
perience. 

Dr. Kirkbride has gone forever from the sight of his fellow- 
men, but his example of humanity, of industrious devotion to 
duty through a long life and of Christian character remains to us 
and to all coming generations, and I earnestly commend it to 
ourselves and to them as one that it will always be wise to follow. 

Dr. Gray : Gentlemen, you have heard the resolution of Dr. 



II 

Curwen. Those in favor of the resolution will so signify by- 
rising. . 

The resolution was unanimously adopted. 
On motion of Dr. Nichols, it was 

Resolved, That the Secretary be directed to forward to the Direct- 
ors of the North Carolina Insane Asylum the appreciation by the 
Association of the spirit which dictated the resolution in regard to 
Dr. Kirkbride. 

On motion of Dr. Nichols, it was 

Resolved, That the Secretary be requested to communicate to Mrs. 
Kirkbride so much of the resolution just adopted by this body as 
relates to her late husband, with the expression of the sympathy 
with which this Association unites with his kindred in lamenting 
his death and honoring his memory. 

On the re-assembling of the Association, Dr. Everts said : 

Mr. President : During the proceedings of the morning in 
relation to Dr. Kirkbride, I presume many other members of the 
Association, like myself, felt that silence was a more satisfactory 
expression of their feelings than anything else, and the matter 
passed without such notice as, I think, becomes this Association. 
I therefore move that a committee of three be appointed to whom 
shall be referred everything, in memoriam, respecting Dr. Kirk- 
bride, and I wish distinctly to decline any place on the commit- 
tee myself. 

The motion was seconded by Dr. Nichols and unanimously 
agreed to. 

Dr. Gray : As Dr. Everts has distinctly declined to be a 
member of that committee, the Chair would name Dr. Curwen, 
Dr. Nichols and Dr. Callender, as such committee. It is also 
understood, I believe, that Dr. Earle and others will communi- 



cate in writing to the committee what they desire to say in regard 
to Dr. Kirkbride. 

At the close of the sessions the following resolution drawn by 
Dr. J. H. Callender was unanimously adopted : 

The Association of Medical Superintendents of American In- 
stitutions for the Insane, about to terminate its meeting in this 
city, in which it was organized forty years ago, and in which it 
has held seven of its annual meetings, in the customary resolu- 
tions on the occasion is inspired by mixed emotions. The selec- 
tion of Philadelphia for this meeting was mainly induced by the 
hope of the presence at its deliberations of one of its venerable 
and eminent founders, whose weight of years and declining 
strength was known to the membership — the late Thomas S. 
Kirkbride, M. D. The inscrutable wisdom of Providence has 
frustrated that hope. His face was not among us, but the mem- 
ory of his abilities and his rare virtues was left to us to honor, 
and will be green as long as the Association shall survive. 



13 



MEMOIR, 



In the company of those who left England with William Penn 
to seek greater liberty of conscience and freedom of worship, 
was a family from the northern part of the county of Cumber- 
land, who settled on a farm on the beautiful banks of the Dela- 
ware river, in Pennsylvania, a few miles above what afterwards 
became the capital of New Jersey. On this farm on July 31, 
1809, was born Thomas Story Kirkbride, who inherited and 
cherished the religious faith and strong love of freedom which 
had led his ancestor to leave his native land and settle in what 
was then a wild and unexplored section of the country. 

The early years of our friend were spent on this farm, and 
from the pleasant surroundings and beautiful scenery which met 
the eye was early derived that love of the beautiful in nature and 
fondness for laying out and adorning the grounds which formed 
so marked a trait in his character. 

His own account of his " schooling" is as follows : " ist, 
home, by my • father, who had been a teacher for a short time ; 
2d, Morrisville ; 3d, Fallsington, three miles distant, often walk- 
ing in both directions, and at other times sent with some one 
connected with the farm ; this continued for several years ; 4th, 
Trenton, to the Classical Institution conducted by the Rev. Jared 
D. Fyler, a very accomplished scholar, and a teacher of rare 



14 
ability, reaiaining four years under his care, devoting the time 
to my classical studies, and then giving a year to the study of 
the higher mathematics, under the care of John Gummere, at 
Burlington, New Jersey. The greater part of the following year 
was spent at home, on my father's farm, in the practical pursuits 
which I felt in later years to have been a permanent advantage 
to my health. During this there was really considerable work 
done in practical farming, and in the case of various kinds of 
farm stock, especially sheep, of which my father had a large 
number, I took a special interest in these, and became so familiar 
with them as to recognize them by their physiognomy. 

" At the close of this agricultural year I commenced reading 
medicine with Dr. Nicholas Belleville, a very distinguished phy- 
sician and surgeon, who came to this country with the French 
forces under Lafayette in the Revolutionary war, and who was 
prevented returning to his country by his great suffering during 
his long voyage of more than sixty days, — so great, that he de- 
clared that nothing could tempt him to run the risk of having to 
undergo an equal period of sickness, — so that he decided to re- 
main in the United States, and settled in Trenton, where he 
married. I was his last private pupil, and he devoted a large 
amount of time to my private instruction. He was a profound 
scholar, a great reader, and had a practical knowledge of his 
profession rarely equalled. I read in his office one year before 
attending my first course of lectures in the University of Penn- 
sylvania, which was in the winter of 1828-9, attending the two 
subsequent years. I graduated in the Spring of 1832." 



He graduated from the medical department of the University 
of Pennsylvania in the Spring of 1832, and was very shortly 
afterwards appointed Resident Physician of the Asylum for the 
relief of those deprived of the use of their reason, at Frankford, 
remained there one year and was then elected Resident Physician 
of the Pennsylvania Hospital, where he remained two years, and 
had renewed opportunities of studying the subject of mental 
disorders in the department of that Hospital which, for eighty 
years, had been specially set apart for that class of disorders. 



15 
After leaving the Hospital he oj^ened an office in Arch street, 
below Fifth street, and with a strong predilection for surgery he 
had intended to devote his attention to that branch. " It was 
during this period, that I began to look forward to securing at 
some future day the position of attending Surgeon of the Penn- 
sylvania Hospital, having always felt that the place of clinical 
lecturer in that Institution, was one of the most honorable and 
"useful that could be held by any individual, and in my estima- 
tion far more desirable to one who expected to be engaged in 
active professional life than a professorship in any medical 
school. My intimacy with the members of the Board of mana- 
gers, and the friendly feelings they were kind enough to express 
in my favor, led me to believe that whenever a vacancy should 
occur in the place to which I aspired, I should have little diffi- 
culty in securing it. This did happen in 1840 ; when my inti- 
mate friend, Dr. J. Rhea Barton, resigned the position he had 
so long held as attending surgeon, he was kind enough to use 
his influence in my favor in filling the place he was about to 
leave, and from a majority of the Board of Managers I had 
assurance which left little doubt in my own mind, but that when 
the election was made, I should be the successful candidate. 

" Just at this time, however, occurred one of those incidents 
that seem beyond the control of men, and which changed the 
whole course of m^y life. One summer morning while walking 
on Race Street, I met my friend John Paul, an active and most 
useful member of the Board of Managers, who asked me with 
apparent interest, what would induce me to go over the river, to 
take charge of the new Hospital for the Insane. To this I re- 
plied, that he was well aware that I was looking forward to 
another position, and for which I had been preparing myself 
during my professional life, and which I now seemed to have a 
reasonable prospect of securing; 'and besides,' said I, 'there 
are one or tvvo other gentlemen who would like the place, and 
who have personal friends in the Board of Managers, and one of 
whom, at least, would seem to have claims that I have not, from 
the long services of hts father in connection with the Institu- 
tion.' ' Yes,' said he, ' I am aware of all that, but, at any rate 
take the matter into consideration.' I told him I would do so 



and see him before any long period should elapse. It was a 
matter for very serious consideration. Certain things were ob- 
vious to me ; that there never had been such an opening for a 
surgeon in Philadelphia and hardly ever would be again. At the 
same time the labor attendant upon the successful practitioner of 
private surgery, and of hospital surgery in addition, must neces- 
sarily be great and would demand more than ordinary good 
health. My professional friends, especially Dr. Rhea Barton, 
regarded such a change in ray plans as ill-advised, and for which 
I could hardly find a justification. On the other hand, I saw 
that from the first I was to have a comfortable residence, a rather 
liberal salary, the opportunity of starting a new institution, and 
developing new forms of management, in fact giving a new 
character to the care of the insane, and possibly securing for 
myself a reputation as desirable as that which I might objtain by 
remaining in the city. Besides my parents favored my acce23t- 
ing this new office as being a certainty in place of an uncer- 
tainty, and, beyond all else, my young wife approved the plan, 
knowing as she did, that a successful city practice must necessa- 
rily keep me most of my time from home, while the care of the 
Hospital for the Insane would be sure to keep me somewhere on 
its premises. When I called upon Friend Paul ultimately, 
therefore, I told him that I had decided that in case I was elected 
without any application on my part, or my having to see any of 
the Managers, and with a promise of a salary that had been 
mentioned by another applicant, I would consent to accept the 
position. The election for Superintendent of the Hospital for 
the Insane taking place on the 12th of October, before that for 
the vacant place of Surgeon to the Hospital at Eighth and Pine 
Streets, necessarily involved an abandonment of my application 
for the latter position. The election took place on the day 
named, and my election was made in the way I had mentioned 
to the friend who had sought my acceptance of the position." 

After examining the several institutions for the insane which 
had been constructed during the last few years previous to that 
date, he entered on the duties of the new position on the first 
day of January, 1841, and the first patient was received on Jan- 
uary 9, 1841, and in a short time all the insane from the hospital 



17 
in Pine street were transferred to the new Institution. He gave 
himself, mind and heart, to the duties of his position, and his 
zeal and enthusiasm for the welfare of the insane never slackened 
so long as life endured. 

Any one who will read the report of the first year of his ad- 
ministration will see clearly laid down the principles which guid- 
ed and governed in all the years which followed ; and enlarged 
experience, a more thorough knowledge and more ample means 
enabled him with each succeeding year, to add to the resources 
of the Hospital and the more thorough treatment, medical, hy- 
gienic and moral, of those committed to its care. In the earlier 
years of the Institution great attention was given to laying out, 
adorning and the careful improvement of the grounds within the 
enclosure, embracing forty-one acres, so that ample walks for 
exercise, pleasant drives and cheerful views and surroundings, 
might direct from morbid fancies to more healthful ideas. The 
attention given to these matters was the relaxation from more 
exacting and imperative duties, and gave that degree of out-door 
exercise which one, in the delicate physical condition and feeble 
digestion which troubled him at that time, so much required, to 
give tone and vigor to his whole system. 



In October, 1844, the Association of Medical Superintendents 
of American Institutions for the Insane held its first meeting in 
Philadelphia, and Dr. Kirkbride was elected its first Secretary, 
and from that day to the close of his life, he always manifested 
the warmest interest in its welfare and progress, and took a very 
active part in all its proceedings, rarely being absent from a 
meeting. 

The ablest deliverances of the Association on the construction 
and organization of Hospitals for the Insane and on kindred 
subjects were from his pen, and were so carefully and thought- 
fully prepared that after The fullest discussion, by all the mem- 
bers, very little change was made in the phraseology and none 
in the sentiments or opinions advanced. 



i8 

He was Secretary of the Association for seven years, Vice 
President for seven years, and President for eight years. 

His position at the head of the oldest Institution for the 
Insane in the country, and at the centre of medical education, 
naturally drew to him all those who were anxious to learn the 
latest and best plans and arrangements for the construction and 
arrangement of hospitals for the insane. He was constantly 
consulted in the arrangements of the State Lunatic Asylum at 
Trenton, and to some extent in the plans of the State Lunatic 
Hospital at Harrisburg. These frequent consultations, joined 
with a natural fondness for architecture and building, led him to 
prepare his book on the construction of hospitals for the insane, 
the first edition of which appeared in 1856, and the second and 
enlarged edition in 1880, having been arranged and prepared 
for the press during the convalescence from a severe illness 
which lasted many months and brought him very close to the 
borders of the unseen world. 

In no work in the English language are the true principles of 
the construction, arrangement, and organization of hospitals for 
the insane more lucidly and more thoroughly set forth than in 
the last edition of that book, and were its precepts obeyed and 
its plans more closely followed, very few of those mistakes would 
be made in the arrangement of hospitals which give so much 
trouble and are so costly in their rearrangement. 

He early entertained the idea of the separation of the sexes in 
buildings under the same general management, and this plan was 
more fully developed in the report for 1854. He labored with 
the greatest assiduity to collect by private subscription the money 
needed for the erection of such a building on the part of the 
property west of the hospital then in operation, and so faithfully 
did he give himself to this work and so zealously was he support- 
ed by the Managers of the Hospital that the greater part of the 
money was subscribed, and " the first stone of the new building 
was laid on July 7, 1856. 

" The formal laying of the corner-stone took place on the first 
of October, in the presence of a large number of ladies and gen- 



19 

tleinen ; on which occasion addresses were made by Professor 
George B. Wood, M. D. ; Richard Vaux, Mayor of Philadel- 
phia ; Mordecai L. Dawson, President of the Board of Mana- 
gers, and Morton McMichael. 



"The building was formally opened for the reception of pa- 
tients on the twenty-seventh of October, 1859. The cost of the 
new Hospital with all its out-buildings, the wall surrounding its 
grounds, all its varied and expensive fixtures of every kind and 
the furniture in use, amounted to the sum of ^3555907.5 7. This 
whole sum has been paid, or there are in hand abundant means 
for doing so, to be derived from unrealized subscriptions and 
from ground rents. 

"The fact that this whole work has been provided and paid 
for entirely from private subscriptions is worthy of remem- 
brance in our local history." 



When the Board of Trustees of the Pennsylvania State Luna- 
tic Hospital at Harrisburg was appointed by Governor Wm. F. 
Johnston, in 185 1, Dr. Kirkbride was one of the Board, and 
continued in service until 1862. He took an active and ener- 
getic part in the organization of that Hospital, and his long ex- 
perience and thorough knowledge gave him an influence with his 
colleagues which he exerted to place that institution in the best 
possible condition for the promotion of the welfare of its in- 
mates ; and no man ever had a more faithful and efficient friend 
and counsellor in all matters than the Superintendent of that 
Hospital during his connection with it as Trustee. Of his con- 
nection with the Pennsylvania Institution for the Blind for more 
than forty years, and the great interest manifested in the design 
and successful' operation of that institution, and the great faith- 
fulness displayed in the very constant attendance at all the meet- 
ings of the Managers, from few of which he was absent during 
the long period of his service, others can better speak who are 
intimately connected with it, but it may be permitted in this 
place to say from personal knowledge that, next to the Hospital 



20 

of which he was Superintendent, no institution held a higher 
place in his regard and affection. 

He received from Lafayette College the Degree of LL.D. in 
recognition of his eminent ability and tiie remarkable services 
rendered to suffering humanity. 

While Dr. Kirkbride, by reason of his great ability and calm, 
deliberate judgment, was called to the discharge of such import- 
ant trusts, that to which his life was really devoted and by which 
he will always be best known, was as Superintendent and Physi- 
cian-in-Chief of the Pennsylvania Hospital for the Insane. 
Assuming the administration of that trust with reluctance and 
hesitation of his own ability properly to discharge its duties in 
the spirit and in the manner in which he believed all such duties 
should be performed, he gave himself, mind and heart, to the 
work, in the spirit of his oft-repeated maxim — what was his duty, 
was his pleasure. 

Association and friendship of the most intimate character, for 
almost forty years, and constant correspondence for more than 
thirty years, give to the writer an opportunity of an acquaint- 
ance with all his views on matters of common interest in the care 
of the insane, which enables him to speak in the most positive 
manner of what those views and opinions were. In every move- 
ment in medical societies, in the Legislature or in any other way 
which had a bearing on the care and treatment of the insane, 
Dr. Kirkbride, though not in all cases prominently before the 
public, was always consulted and his counsel and advice earnest- 
ly sought, and for thirty years, and these were years in which 
legislation was most active in that direction, no measure of any 
importance was enacted in the inception and progress of which 
he was not fully consulted in all the stages, and he never hesita- 
ted to use all his influence with those with whom it would be 
most effective, either in favor of any measure which might pro- 
mote the welfare of, or against any which might be injurious to 
that class in which he was so greatly interested. A proper esti- 
mate of his life-work can best be obtained by a careful consid- 



eration, in the briefest manner to render them clearly intelligible, 
of the various subjects which constantly and steadily claimed his 
thought and attention. No man ever gave more careful, assidu- 
ous, well directed and intelligent thought to all matters connect- 
ed with the construction of hospitals for the insane, and the fact 
that the plan he elaborated, and which bears his name, has been 
incorporated in buildings from the St. Lawrence to the Gulf of 
Mexico, and from the Atlantic to the Rocky Mountains, clearly 
proves its thorough adaptation to the purpose. It has been the 
fashion with some, who, with no practical experience, have 
pushed themselves forward in matters connected with building 
hospitals, to decry the plan as behind the age ; but their plans 
have not yet been tried sufficiently long to prove their defects in 
all respects, and those defects will be found at the very points 
where they have departed from the well-considered details which 
he so carefully worked out. 



" So different from ordinary buildings or other public struc- 
tures are hospitals for the insane, that it is hardly possible for an 
architect, however skillful, or a board of commissioners, how- 
ever intelligent and well disposed, unaided, to furnish such an 
institution with all the conveniences and arrangements indispen- 
sable for the proper care and treatment of its patients. Nothing 
but a practical familiarity with what is required can do this. All 
recent experiments in planning hospitals without consulting ex- 
perts, or asking their opinions before the adoption of the plan, 
as should be expected, have proved failures. No desire to make 
a beautiful and picturesque exterior, should ever be allowed to 
interfere with the internal arrangements, any more than the wish 
to have an elevated and commanding site should be permitted 
to compel the provision of costly roads, and the expense and 
annoyance of having everything, in all future time, carried to its 
great elevation. The interior should be first planned, and the 
exterior so managed as not to spoil it in any of its details. 



"Although it is not desirable to have an elaborate and costly 
style of architecture, it is, nevertheless, really important that the 
building should be in good taste, and that it should impress fav- 



orably not only the patients, but their friends and others who 
may visit it. A hospital for the insane should always be of this 
character, it should have a cheerful and comfortable appearance, 
everything repulsive and prison-like should be carefully avoided, 
and even the means of effecting the proper degree of security 
should be masked, as far as possible, by arrangements of a 
pleasant and attractive description." 



This is not the place, nor would time permit, to go into an 
elaborate description of the plan, but it may suffice to state that 
its main features consisted of a central building for all the ad- 
ministrative offices, with wings on each side ; the first wing at 
right angles to the centre, and at the point of junction a space 
of ten feet left with windows from floor to ceiling to give ample 
light ; the second wing parallel with the first, but thrown back 
so as to have windows from floor to ceiling at both ends of the 
hall, and the third wing still parallel to the second, and the win- 
dows of a similar character at both ends of the hall. From this 
fact of the wings running parallel with each other, it has been 
called also the linear plan. The halls of the wings are twelve 
feet wide, and the ceilings of each story twelve feet high ; rooms 
on both sides of the hall, and in the centre of the hall large bay 
windows to give light, and afford a pleasant sitting-room for the 
inmates, in addition to the large parlor; every ward to have in it 
all those conveniences which may be requisite to promote the 
comfort and well-being of those for whose use the hospital is 
constructed. The whole establishment to be so arranged as to 
be under one roof and in every part to be as light, bright and 
cheerful as it is possible to have it, and with the object of pro- 
moting the comfort and convenience of all, with the least ex- 
penditure of time and labor. 

Any one wishing to be thoroughly conversant with all the 
details of construction of hospitals for the insane, should read 
attentively this work on the construction and organization of 
hospitals for the insane. The work will be found most admira- 
ble for the clearness of all its statements on the different points, 
most thorough in its elaboration of details, and bearing in every 



23 

line the impress of a clear head, sound judgment and most inti- 
mate acquaintance with everything which can have a bearing on 
the promotion of the restoration, comfort and welfare of the in- 
sane, directed and guided by that earnest conscientiousness 
which was such a prominent trait in his character. 



In forming an opinion on any subject he was never hasty, but 
submitted all to the careful scrutiny of a sound judgment, which 
led him to examine with a full knowledge of all the facts bearing 
on the point which could be obtained. A warm, generous 
heart, keenly alive to all the finer impulses of humanity, led him 
so to direct all his thoughts and actions that self had no promi- 
nence, but the good of others and the advancement of their 
happiness was the great aim and object of all his efforts. The 
more intimately his opinions, on every subject to which his 
thoughts were directed, are known, the more thorough will be the 
conviction of each mind, that every faculty of his mind and 
every impulse of his heart urged him onward in the path of 
entire devotion to the welfare and happiness of all he could 
reach. 



No uncertain sound attended his utterances on all matters per- 
taining to the welfare, care and treatment of the insane, and the 
mild and pleasant manner in which his opinions were expressed 
served to carry conviction to many minds which would have re- 
sisted a more dogmatic expression,, and added force was given 
by the evident sincerity and devotion to truth and duty which 
dictated them. No more positive indication of the confidence 
reposed in his judgment, and the earnestness and sincerity with 
which he urged his views, can be looked for, than in the collec- 
tion of the large amount for the erection of the Department for 
Males of the "Pennsylvania Hospital for the Insane, by far the 
larger portion of that amount having been obtained by his per- 
sonal efforts in direct application to individuals, and any one 
who will examine that long list will see the uncommon tact and 
energy displayed by him in his appeals to all classes and condi- 
tions of men. 



24 

On all matters pertaining to the welfare of the insane his 
opinions were clear and decided, and formed with a care, discre- 
tion and deliberation which those would do well to imitate who 
so freely criticise and often so summarily reject them. To some 
of those opinions on matters which have been so much discussed 
in late years, attention must be given in order to obtain a clear 
idea of the work which he performed, and the clear head and 
generous heart which directed that work. 



A careful examination of the forty-two reports prepared by 
him during the long period of his superintendency will make 
clear the thoroughness and fidelity with which he considered all 
matters pertaining to the care of the insane. Those reports will 
be found to contain discussions on every matter which was cur- 
rent at the time they were written, and the calm and judicial 
manner in which each was treated as it arose will impress the 
reader with the thought that the truth of what was stated was 
self-evident to the writer's mind, and influenced all his plans and 
thoughts. No better guide for a young man entering the spe- 
cialty could be found to instruct him what he should do and the 
special duties which he would be called upon to perform. 

" It must be remembered that these reports were penned, not 
in the seclusion of the student's closet, nor as the fruit of that 
retirement which often produces fair but untried theories, false 
to philanthropy because untrue to experience, but by one fresh 
from the hourly duties which pressed upon him, testifying of 
what he saw, and speaking of what he knew. His exhortations 
to kindness and consideration, and practical wisdom in the care 
and treatment of the insane, both acute and chronic, his de- 
scriptions of the high character needed in persons occupying 
any position in an institution specially provided for these suffer- 
ers, were written in moments snatched from his unceasing labors, 
and perhaps just after having his patience and his tenderness 
sorely tried in soothing the irritable, or comforting the sad, or 
calming the excited, or possibly, this was still more trying, 
after being made grievously aware that much of the best aid he 
could secure in his great task was, at times, sadly below his ideal. 



25 

Indeed it was a frequent remark, that he never had any trouble 
in managing the insane, but that his only difficulties lay in the 
management of the sane. After his return to his own home 
from his duties at the Hospital, the interruptions to his literary 
work and to his correspondence, which often involved much 
serious thought, and of which from first to last he took unaided 
charge, answering with his own hand every letter of every kind 
requiring a reply, w-ere almost endless. 

" Friends of patients came for inquiry or to seek merely the 
comfort his words afforded. Applicants for the position of at- 
tendant sought him, brother physicians called to talk over some 
obscure case, husbands or wives, brothers or sisters, parents or 
children, brought their afflicted dear ones to ask his counsel in 
their need — such visits often requiring a long and separate inter- 
view with each party — mechanics came to seek their orders about 
the building or the improvements continually on hand, patients, 
nurses, employes or officers from the Hospital asked his quick 
decision upon some knotty point, the decision not always shut- 
ting off subsequent discussion. 

" It is a curious fact in this life of much correspondence and 
other work with the pen, that neither at the Hospital, nor in his 
own home, had he a spot exclusively his own, where either in 
study or consultation could he be sure of not being, at least, 
looked in upon, by those with wiiom he shared his right to each 
apartment. His library at his own house, was also the dining 
room and the favorite room of the home ; there stood his desk 
and chair; there he wrote, and planned and thought; there his 
older children centered all the sweetest and most sacred memo- 
ries of their early lives ; there in later years his younger children 
and his grandchildren, never dreaming of causing annoyance, 
for annoyance was never shown or expressed, came to play un- 
checked, and to seek the unfailing sunshine of his presence." 

The employment of mechanical restraint has in late years re- 
ceived more than usual attention in the reaction from its exces- 
sive use in England many years since, and on a subject of such 



26 

practical importance in the treatment of the insane, it is only just 
to quote the opinions of one who had the most ample means of 
testing it, and who, while believing in its use in certain specified 
cases, rarely, to use the words of Dr. J. C. Bucknill, of England, 
carried his theory into practice. His uniform testimony, derived 
from careful observation and experience, for he had seen its 
modified use while resident physician of the Friends' Asylum, 
and of the Pennsylvania Hospital in Pine street, and holding 
that opinion, not because he had formed it, and was reluctant to 
change it, but simply because he believed that the best interests 
of a certain class of insane, and that a very limited number re- 
quired it for their benefit, was, in the language of a resolution of 
the Association of ^^ledical Superintendents of American Insti- 
tutions for the Insane, adopted in October, 1844: " That the 
attempt to abandon entirely the use of all means of personal re- 
straint, is not sanctioned by the true interests of the insane." 
That resolution was drawn by men, who carefully considered the 
words they used before committing them to paper. 



Dr. Kirkbride discussed the subject in his reports, from the 
year 1841 down to 1877, in which latter year he used the follow- 
ing language as a full summary of his views : "It is an error 
leading to wTong popular impressions, to speak of any hospital 
for the insane as being conducted without restraint. There is 
no such thing, and cannot be. Where an individual is placed 
under the control of another, even where the control is of the 
gentlest kind, it can hardly be said he is without restraint. 
What is meant is, not that a hospital is without restraint, but is 
without mechanical means of restraint, and these can be omitted 
anywhere on provision of the proper substitutes. Mechanical 
restraint is rarely necessary, and only in a few, simple forms, but 
when it is required, it is a question to be left for the decision of 
whoever directs the treatment of the patients. No one recogrii- 
zes more thoroughly than is done here, the impropriety of sub- 
jecting the insane to unnecessary restrictions, and that the pre- 
cise extent to which freedom of action may be carried can only 
be discovered by careful observation and the study of the pecu- 
liarities of every individual patient. The only persons who can 



27 

properly decide just how far restrictions shall be carried, and 
freedom be granted in an institution, are its medical officers, 
who, having all the responsibility for the results, if at all qualified 
for their positions, may safely be entrusted with the power to de- 
cide all such questions, which should really be regarded as a part 
of the treatment of the patients." 

Tn the matter of occupation, employment and amusement of 
the inmates of a hospital, Dr. Kirkbride always held advanced 
opinions, which the great majority of men have not yet attained 
to. He held, and held justly, as every reflecting man must ad- 
mit, that some means of diverting the mind from morbid ideas 
to more healthy thoughts, was as important as medicine to a 
disordered bodily system, and that the two must be carefully 
adjusted to the condition of the individual at the time. He was 
never satisfied with what he had done, but was always reaching 
out for something newer and better in addition to those already 
in use. This idea runs through all his reports, like a golden 
thread, to brighten and strengthen them. In reference to occu- 
pation, a wise caution is given, which should be carefully pon- 
dered, if they could do such a thing, by those whose ill-digested 
opinions indicate a much greater amount of zeal than knowledge. 

" Moderate, wisely regulated labor is really serviceable to 
many of the insane, but hard work, so carried on as to be profi- 
table to any institution, is very rarely of benefit to the patients, 
while often it is injurious to an unsuspected extent, to a class 
whom the excitement of disease stimulates to extraordinary exer- 
tion. Besides these, there are others who uncomplainingly labor 
at the tasks assigned them, only because they are urged to do so, 
when their natural instincts would lead them to enjoy the rest, 
for which they have a personal craving, and which comes from 
an actual want of strength dependent on the existence of disease. 
It is never to, be forgotten by those having charge of the insane, 
that much as the malady differs in form and degree, all of these 
cases are as truly the subjects of a serious disorder in a delicate 
organ as are those who have any other sickness, in which the 
sufferers may be so much better able to describe their true condi- 
tion, and to secure proper attention to their wishes. In provid- 



28 

ing day occupation for the insane, much of it must be very dif- 
ferent from the hard work from which alone any material profit 
can be anticipated. For much the larger portion of the patients, 
walking or riding through the grounds, or in their vicinity, with 
all the attractions that can be connected with them, will be much 
more valuable as remedies and nearly as profitable pecuniarily, as 
labor usually is. Every one of the many forms of diversion that 
should always be liberally provided, and all the games, out-doors 
and in-doors, especially those that give active exercise in the 
open air, have a positive value, and really contribute more or 
less to the great objects for which these hospitals are established. 
The labor problem in regard to the insane is probably best set- 
tled by the conclusion, that it is hardly possible to exaggerate 
the importance of occupation of some kind for every class, but 
also, that harm, quite as easily as good, may follow employment, 
in unwise forms, and that a practical knowledge of the whole 
subject in regard to kind, amount, and the physical and mental 
conditions of those on whom its effects are tried, is indispensa- 
ble to secure the best results from its use. 

" The necessity for entertaining and amusing the patients of a 
hospital for the insane, and giving them suitable varieties of oc- 
cupation — no matter what is the character of the institution — is 
now generally conceded. For the day-time reasonably good 
arrangements are commonly made for effecting these objects, but 
there is a long period in the evening — often amounting to sev- 
eral hours — when out-door pursuits are suspended, and when, 
without carefully S3'stematized arrangements, the patients go 
through a dreary period of monotonous and unprofitable exist- 
ence, for which there is really no necessity. If it is desirable to 
correct this state of things for one evening of the week, it is 
equally so for every other. It is no more difficult to make these 
evening entertainments a daily provision, allowing nothing to 
interfere with their regular performance, than it is to provide for 
the numberless other needs that come up at stated intervals in 
the daily routine of hospital life. In making out the estimate 
for the provision or support of any of these (State or municipal) 
institutions, a liberal allowance should always be made for suit- 
able rooms for these purposes, for books and papers, for inex- 



29 

pensive pictures for the walls, for many occupations and for eve- 
ning amusements in all their variety; and most assuredly no part 
of the expenditures — although this may do its work ever so 
quietly — will more certainly contribute to the happiness and im- 
proved condition of the patients, or tend more to elevate the 
character of the institution, giving abundant returns for all the 
money thus appropriated. These are a part of the varied means 
which are sure to aid in the restoration of those who are cura- 
ble, in securing the comfort and happiness of those who are not 
likely to be restored to health, and the quiet and good order of 
the household." 



To trace out and understand the wonderful influence which he 
had over his patients, and how he induced them to adopt most 
readily the plans which he believed would surely advance their 
restoration and add to their comfort, can best be done by con- 
sidering his wonderful patience, and his devotion to everything 
which had a bearing on their welfare, and the sincerity which 
they felt sure directed every thought and movement. His 
thoughtful nature was always looking forward to what could be 
made most steadily and certainly available for their pleasure and 
for the promotion of their mental and physical health. Until 
the erection of the Department for Males, he made it a rule to 
see all the patients under his charge in the morning, and if any- 
thing prevented that visit, he was sure to take an opportunity in 
the course of the after part of the day, to attend to what he 
considered a most imperative duty. That visit was not a mere 
perfunctory duty, but he always took occasion to inquire, par- 
ticularly, into the wants and feelings of the individual, hear all 
that he had to say, give advice, soothe, cheer, or so impress the 
person with his interest in him, and his earnest desire to benefit 
him, that he felt in every way, for the time, relieved, and looked 
longingly for the return of the same kindly attention. His 
manner, his address, his patient listening to all complaints and 
grievances, the gentle tone of his voice and the sympathy which 
manifested itself in every tone and action, had a wonderful 
effect on those who were depressed and greatly cast down, as 
well as on those of an opposite character. 



30 
''The peculiar feeling of restfulness in the mere knowledge of 
his being near, was probably never so fully realized by any, as 
by his female patients. The mere report in the morning that 
Dr. Kirkbride was absent for the day, caused a strange sense of 
loss ; his short yearly vacations, only twice during his long ser- 
vice prolonged to four weeks, and generally lasting but three or 
less than three, were weeks when personal troubles were hardest 
to bear, and delusions of the mind most consciously painful ; 
while his return, even to those with whom insanity meant black- 
est despair, brought an emotion more nearly akin to glad relief 
than any other the sufferers knew." 

One, not long since his patient, writes: "I have never 
known any one whose presence commanded such reverence and 
love. It was only the other night, I woke in great fright ; I was 
too frightened to call, but I suddenly thought of Dr. Kirkbride, 
and, as I thought, it seemed to me that I could see him distinct- 
ly though the room was dark, and immediately I felt that peace 
and freedom from danger that Dr. Kirkbride always inspired." 

Great as was the interest he took in directing the building and 
improvements of the place and great as was his ability in these 
respects, it was within the wards that he found his chief delight, 
and there also that the strength and the graces of his nature 
showed themselves more clearly. In 1849, he wrote: ''The 
buildings of the Hospital being now completed, the undersigned 
looks forward with great satisfaction to the increased amount of 
time, which he hopes to be able to give to the interior of the 
establishment, and to perfecting the means of restoring mental 
and physical health, and smoothing somewhat the rough places 
on the road of life, of those who must look to this spot as their 
earthly home." To know him thoroughly, one needed to see 
him in the wards surrounded by those to whom his life was de- 
voted. Perhaps, also, none knew him so well, or so thoroughly 
appreciated his power over the insane as those restored to reason 
under his care ; for they had felt and realized in themselves the 
effects which others had only seen. None prized so truly the 
value of his words and even of his looks, as those who in the 
sore distress of mental suffering and despair, or amid the vaga- 



31 

ries of a disordered intellect, had felt the soothing, calming in- 
fluence of a spirit which, whatever its inward struggles might 
have been, gave to others the impression in all outward show of 
speech, and look, and tone, that it had reached a centre of re- 
pose." " How conscientiously from the first Dr. Kirkbride ex- 
ercised this personal ministry, more potent, perhaps, in itself 
than the many remedial agencies, gathered within the institution, 
such sentences as the following, taken from the earliest reports, 
give a clear idea : "At the visit of the Physician and his assist- 
ant, which commences at half- past eight o'clock in the winter, 
and at eight o'clock during the summer, every patient is seen 
and spoken to — unless there is some special reason for an excep- 
tion." "No favorable opportunity is neglected for personal 
intercourse with the patients, and for free and friendly conver- 
sation on any subject in which they are interested ; not except- 
ing, in many instances, their own cases and their own peculiari- 
ties or those of their neighbors. Discrimination is, of course, 
to be observed in this, as in every other matter connected with 
the insane ; with some few patients, it is advisable that no allu- 
sion to the character of their disease should ever be made ; but 
with others, advantage results from a different course. Many, by 
a free and candid conversation on the whole subject, are taught 
to take a correct view of their disease — to look upon it as upon 
many other afflictions to which all are liable, and not as a hope- 
less one, nor as one so terrible that all allusion to it must be care- 
fully avoided." " The officers endeavor never to let a favorable 
opportunity for direct mental treatment to pass unimproved." 
"To those familiar with his marvellous perseverance, and ac- 
quainted with his methods of unwearied eff'ort in long conversa- 
tions with his patients, there is much that is suggestive in these 
quotations." 

To the writer of this memoir a lady used the following langu- 
age : "I attribute my restoration to sound reason entirely to the 
long, frequent and cheering conversations which Dr. Kirkbride 
had with me." "Dr. Kirkbride's attitude to the successive 
Boards of Managers of the Hospital, was always that of one en- 
trusted by others with a great service, and responsible to them 
for the strictest stewardship. Untiring diligence, unceasing 



32 

labor and the greatest conscientiousness were the cheerful price 
he paid. ' No man ever had more pleasure in his work than I, 
it was always a pleasure when I was well,' was the remark he 
made during his last illness in looking back upon his life." 

It may not be out of place to quote a saying which he fre- 
quently repeated : " My duty is my pleasure," and that seemed 
to be one of the ruling principles of his life. 

The advancement of the Association in every honorable man- 
ner, and enunciation by it of sound principles on every subject 
connected with the welfare of the insane was always prominently 
before his mind, and his zeal in its cause was characterized by a 
warmth of feeling which found expression whenever its interests 
were considered ;' and he never failed to attend its meetings 
whenever his health would permit ; and he was absent but eight 
times from the formation of the Association until his last sick- 
ness and from these meetings he was kept by sickness in his 
family, his own ill health or by duties which could not be post- 
poned ; and the last message sent by him to the Association only 
six months before his death showed the earnestness and enthu- 
siasm with which he watched all its proceedings : '' Present my 
kindest regards to all the members, and express to them my great 
Tegret that I cannot be with them in body as I will be in spirit 
and my great interest in all their deliberations;" and to the 
messenger he added this : '^ Let me hear from you all about the 
-meeting." 

Of the deliverances of the Association the following were 
prepared by him and adopted with only a few verbal changes : 
The propositions on construction of hospitals for the insane in 
1867; the propositions on the organization of hospitals for the 
insane in 1853 ; the resolutions on provisions for all classes of 
the insane in 185 1 ; the resolutions on heating and ventilation 
in 1848 ; the resolutions on overcrowding hospitals for the insane 
-in 1872 ; those on didactic and clinical instruction on insanity in 
1872, and those on the reaffirmation of propositions and resolu- 
tions in 1871. 



33 

He was a most earnest advocate of every medical, hygienic 
and moral means, which could be made available for the restora- 
tion and comfort of those placed under his charge, and he 
sought to impress, not only all these views, but all his interest in 
his patients, on those who had more immediate direction. The 
rules, which he prepared for the conduct and guidance of those 
entrusted with the immediate care of the patients, show how 
zealously he sought to impress his own principles and practice on 
all who came within the reach of his influence ; but the example 
of his daily conduct impressed the lesson more deeply than any 
written code could have done. No one could fail to feel the in- 
fluence of that genial, gentle nature, constantly before him, and 
not be impressed with its great worth, and the effect it must ne- 
cessarily have on all who could be reached by it. When the 
physical frame could no longer bear the strain put upon it by 
the constant visits to the wards, in all their detail, the interest 
was still extended to all, but more directly expended on those 
whose restoration could be most certainly effected by it. 

Of a naturally quick and impulsive temper, that was so effec- 
tually under control that none would have suspected its exist- 
ence, unless some wrong or injury were done to the insane, and 
then the rebuke came, sharp and decisive ; not in an angry tone, 
but as the result of that indignation which such a sensitive spirit 
would naturally feel, on witnessing, or becoming acquainted 
with any violation of the better instincts of true manhood. 

Like all genuinely conscientious natures, he was very sensitive, 
and seeking with unaffected honesty and truthfulness to do all in 
his power for the relief of suffering humanity, he was naturally, 
perhaps unduly, sensitive to the attacks made by many, whose 
philanthropic zeal was often assumed to make an impression, in 
their own favor, on their fellow-men. Certain it is, that he was 
very much harassed by the malicious attacks of designing per- 
sons, whose utter lack of true benevolence led them to say and 
do things, totally at variance with truth and justice. When in 
feeble health, and endeavoring to do all in his power for the 
benefit of his fellow-men, he was assailed with very unjust state- 



34 
ments, made by those whose misguided zeal led them to the utter- 
ance of strictures on his character and professional standing, 
which their high religious profession should have made them 
blush to make public, without a more thorough investigation of 
the true facts. In the minds of those who knew him best, the 
impression is very deep that those strictures had very much to do 
in bringing on the condition which ultimately resulted in his 
death. 

Deeply imbued with the religious principles of the Society of 
Friends, in which he had been educated, while placing little 
value on various externals of the Society, he endeavored, con- 
sistently, to carry out the principles laid down by them, in all 
his intercourse with his fellow-men. To a disposition, genial, 
gentle and kind-hearted, he united great decision and determi- 
nation of character, and, convinced after careful examination 
that he was right, he kept steadily on in the course he believed 
to be correct, not deviating in the least from what he believed 
to be the true line of duty. Generous and liberal-minded, 
strong in his attachments and friendships, he cherished no feel- . 
ings of enmity against any, but strove to live in peace and har- 
mony with all ; and, when others refused to act harmoniously, 
quietly going on in the line of duty, avoiding contention while 
adhering strictly to what he believed to be truth and justice. 
His generous mind revolted at all pretences and attempts to 
make the worse appear the better reason, and he scorned all de- 
ception. 



He possessed a wonderful tact in his intercourse with the in- 
sane, which, combined with unfailing good nature and honesty 
of purpose, gave him great power, which he always used to ad- 
vance their interests in the fullest manner. Calm and self-pos- 
sessed in scenes where others were agitated and alarmed, he ex- 
ercised the happy faculty thus enjoyed, with great judgment and 
discretion, thus evincing in the clearest manner his power to di- 
rect and control. No trait of his character was more prominent 
than his single-hearted devotion to every good word and work, 
and in this, and in the earnestness and conscientiousness with 



35 
which his work was performed, he strove to follow the example 
of Him who always went about doing good. 

No man enjoyed more heartily social intercourse, and there 
was a geniality in his humor, and cordiality in all his manner 
which made him at all times a most agreeable companion, and 
those who were admitted to intimacy with him know how kind, 
gentle and sympathetic he was, and how earnestly he strove to 
do all in his power for the happiness of those to whom he was 
attached. 

Of his domestic relations and the great delight afforded him 
by those relations this is not the place to speak fully, and it is 
altogether needless, as the domestic traits of his character have 
been so clearly and so freely delineated by one who could speak 
with the fullest knowledge. 

During the last four years of his life he was an invalid, and, at 
the early part of that period, death seemed so near that all prep- 
arations were made in anticipation of that event, but he was per- 
mitted to enjoy a period of nearly three years of comparative 
health, but not with the return of his physical strength, and 
about nine months before the end came he was taken down, and 
was so reduced that only for a short period was he able to go 
about without assistance. 

He continued to manifest the same earnest interest in all mat- 
ters pertaining to the care of the insane, and his mind continued 
clear and free until the closing time which came shortly before 
midnight of December i6, 1883. His mortal part was laid to 
rest in Laurel Hill Cemetery on a bleak December day, but his 
spirit had entered into the " rest that remaineth." 

At a special meeting of the Board of Managers of the Penn- 
sylvania Hospital, held . December 17, 1883, the following was 
unanimously adopted : 

This Board, having received with sincere sorrow, the intelligence 
of the death of Dr. Thomas S. Kirkbride, Physician-in-chief and 



Superintendent of the Insane Department of this Hospital, desire 
to place on their records some fitting and grateful tribute to his 
memory, both for his great services to tlie institution over which he 
so long and ably presided, and for his high character and worth as a 
man. Dr. Kirkbride's first connection with our Hospital was in 
1833, when he was elected as a Resident Physician in the Pine Street 
Hospital, in which capacity he served most acceptably until 1835. 
When the Insane Department of our Hospital was removed to its 
present site in West Philadelphia, in 1841, Dr. Kirkbride was elected 
the first Physician-in chief and Superintendent of that Institution. 
At this date there was but one hospital baiiding for both male and 
female patients. In 1859, a new Hospital was constructed for male 
patients only, female patients being retained in the Hospital first 
erected, and from thenceforth both were under his care. 



From his election to the post above designated, until his death, 
Dr. Kirkbride has .been continuously elected to office as the head of 
the Department for the Insane, without suggestion or thought, either 
on the part of the Managers of the Hospital or the public, that a 
more efficient or faithful administrator of the duties of this im- 
portant place could be found. 

Dr. Kirkbride possessed in a remarkable degree the characteristics 
and qualities, intellectual and moral, to fit him. for the position he 
so long held. To excellent medical training, and a great aptitude for 
that branch or specialty to which he devoted so much of his life, he 
added a nature full of sympathy for human suff"ering and affliction, 
great natural benevolence and kindness, rare administrative ability 
and great rectitude and moral worth. Possessed of those endow- 
ments, and with a heart full of zeal in his great work, and a keen 
insight into the needs of the patients brought under his care, his 
success in his professional work has been pre-eminent, and his use- 
fulness to the community hard to estimate. It is, therefore. 

Resolved, That by the death of Dr. Kirkbride, this Institution has 
lost a most faithful and efficient officer, whose untiring and well- 
directed labors for some forty years, have not only met with the 
cordial approval and co-operation of this Board, but have wrought a 
high and enduring reputation for him, and for our Hospital for the 
Insane, over which he so long and ably presided. 

Resolved, That Dr.. Kirkbride's works for the relief of the insane 
both in the administration of his office in our Institution, and by his 



37 
contributions to medical literature upon the subject of insanity, and 
its proper treatment, entitle him to rank very high among the bene- 
factors of his race. 

Resolved, That by the death of Dr. Kirkbride we lose a friend, 
bound to us by uncommon ties of affection and esteem. No one 
could come within the range of his influence, without being made 
to feel that his rare endowments of head and heart were such as to 
attract the love and confidence of his fellow-men ; and throughout 
his life he well deserved that love and confidence. 

Resolved, That the Board will attend his funeral in a body, and 
that a copy of these resolutions, attested by the President and Sec- 
retary, be forwarded to the family of our departed friend. 

Willia:m Biddle, 
B. H. Shoemaker, President. 

Secretary. 



38 



In obedience to the vote of the Contributors to the Pennsyl- 
vania Hospital, a handsome marble tablet has been placed in the 
hall of the Department for insane females, on which is the fol- 
lowing inscription : 

This Tablet 

records the affection cherished for the 

memory of 

THOMAS S. KIKKBRIDE, M. D., 

for more than forty-two years 

Physician-in-chief and Superintendent 

of the 

Hospital for the Insane 

in charge of 

the Contributors to the Pennsylvania Hospital. 

In his official duties, faithful and efficient, 

In his profession, skillful and untiring, 

In his benevolence, wise and far-seeing, 

In his Christian faith, sincere and steadfast, 

In every relation of life, tender and unselfish, 

He w^as 

In his practical work in this Institution the firm yet most gentle 

and sympathetic 

Friend and Healer, 

and 

by his life-long and successful labors in behalf of the insane, 

A benefactor of Mankind. 

He died 

at his home, in the grounds of this Hospital, on the 

16th day of 12th month, 1883, 

in the 
seventy-fifth year of his age. 



